Understanding the Florida Workers compensation Claims Process
Workers compensation in Florida aims to provide benefits and compensation to people injured in their workplace. With a few exceptions, most employees in Florida are covered by Workers compensation policies provided by or paid for by their employers. If you are injured, it is important to know the steps to take, what steps to avoid and what benefits you might expect.
If you are injured, report the accident to your employer or supervisor as soon as possible. It is critical to report your injury within 30 days, or you may risk a denied claim. Be sure to report an injury to your employer even if you did not miss any work as a result.
When injured, you must see a physician or medical group designated by your employer or his or her insurance company. If you see your own doctor, you may not be compensated for those medical services.
Your employer is required to contact his or her Workers compensation insurer within seven days of your report. You should then receive documentation explaining your rights and responsibilities and information about the claims process.
Workers’ compensation is a no-fault system designed to provide benefits to employees injured as a result of their employment activities and to limit the liability of employers. Because it is a no-fault system, the employee does not need to prove negligence on the part of the employer to establish liability. It also means the employer cannot use negligence on the part of the employee as a defense to a claim.
A work-related injury can be any condition that is caused, aggravated or accelerated by the employment activities. This includes traumatic injuries, gradual injuries or occupational diseases. The employee needs to show only that the employment activities were a substantial contributing factor to the disability and/or need for medical care.
Workers’ compensation provides four basic types of benefits:
•compensation for the loss of use of a part of the body;
•medical benefits; and
•vocational rehabilitation services
Who is required to have workers’ compensation coverage?
•If your employer is in an industry, other than construction, and has four (4) or more employees, full-time or part-time, your employer is required to carry workers’ compensation coverage (an exempted corporate officer does not count as an employee).
•If your employer is in the construction industry, and has one (1) or more employees (including him/herself), your employer is required to carry workers’ compensation coverage (an exempted corporate officer or member of a limited liability company does not count as an employee).
•If your employer is a state or local government, your employer is required to carry workers’ compensation coverage.
•If your employer is a farmer, and has more than five (5) regular employees and/or twelve (12) or more other workers for seasonal agricultural labor lasting thirty (30) days or more, your employer is required to carry workers’ compensation coverage.
Does my employer have workers’ compensation coverage?
You can contact the Employee Assistance and Ombudsman Office at 800-342-1741 or by e-mail at firstname.lastname@example.org and they can assist you with this question. You can also access the Division of Workers’ Compensation’s Proof of Coverage Database to see if your employer has coverage.